The Journal of Urology
Volume 181, Issue 1 , Pages 193-197, January 2009

Type 2 Diabetes Mellitus and Risk of Stress, Urge and Mixed Urinary Incontinence

  • Kim N. Danforth

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    • ,
  • Mary K. Townsend

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    • Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    • Corresponding Author InformationCorrespondence: Channing Laboratory, 181 Longwood Ave., Boston, Massachusetts 02115 (telephone: 617-525-2764; FAX: 617-525-2008)
    • Supported by the Yerby Postdoctoral Fellowship Program.
    • ,
  • Gary C. Curhan

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    • Renal Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    • Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    • Financial interest and/or other relationship with TAP Pharmaceuticals and Astellas.
    • ,
  • Neil M. Resnick

      Affiliations

    • Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
    • ,
  • Francine Grodstein

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    • Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts

Received 29 April 2008 published online 14 November 2008.

Purpose

To improve the understanding of the etiological relation between type 2 diabetes and urinary incontinence, we examined associations between diabetes and urinary incontinence type in 71,650 women 37 to 79 years old in the Nurses' Health Study and the Nurses' Health Study II.

Materials and Methods

From 1976 to 2000 in the Nurses' Health Study and 1989 to 2001 in the Nurses' Health Study II participants reported diagnoses of type 2 diabetes. Women with incident urinary incontinence at least weekly were identified from 2000 to 2002 in the Nurses' Health Study and 2001 to 2003 in the Nurses' Health Study II. We pooled data from the 2 cohorts, and estimated odds ratios and 95% confidence intervals using multivariable logistic regression adjusting for age, parity, body mass index, smoking, hysterectomy, functional limitations, menopausal status, postmenopausal hormone use, incontinence promoting medications and study cohort.

Results

The incidence of at least weekly urinary incontinence was 5.3% (3,612 of 67,984) among women without type 2 diabetes and 8.7% (318 of 3,666) among women with diabetes. Overall the multivariable adjusted odds of incident urinary incontinence were increased 20% (OR 1.2, 95% CI 1.0–1.3, p = 0.01) among women with vs without type 2 diabetes. This increase appeared largely explained by significantly greater odds of urge urinary incontinence (OR 1.4, 95% CI 1.0–1.9, p = 0.03). There was no apparent association between diabetes and stress (p = 0.3) or mixed (p = 0.6) urinary incontinence, although confidence intervals were somewhat wide.

Conclusions

Our findings suggest that type 2 diabetes may especially influence urge urinary incontinence. Further research is needed to confirm this finding and identify pathways linking these conditions.

Key Words: epidemiology, diabetes mellitus, type 2, urinary incontinence

Abbreviations and Acronyms: BMI, body mass index, NHS, Nurses' Health Study, UI, urinary incontinence

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 Supported by National Institutes of Health Grants DK62438, CA87969 and CA50385.

 Study received institutional review board approval.

 See Editorial on page 13.

PII: S0022-5347(08)02425-7

doi:10.1016/j.juro.2008.09.007

Refers to article:

  • Diabetic Cystopathy—What Does it Mean? , 13 November 2008

    Jeanette S. Brown
    The Journal of Urology January 2009 (Vol. 181, Issue 1, Pages 13-14)

The Journal of Urology
Volume 181, Issue 1 , Pages 193-197, January 2009

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